2020

The Ombudsmen’s Office

2019 REPORT ON NATIONAL PREVENTION OF TORTURE 2019 REPORT ON NATIONAL PREVENTION OF TORTURE

CONTENTS

3 INTRODUCTION

5 NATIONAL PREVENTION OF TORTURE AND THE SEIMAS OMBUDSMEN’S MANDATE

6 ACTIVITIES OF THE NATIONAL PREVENTION OF TORTURE

6 VISITS TO PLACES OF DETENTION

6 INFORMATION ACTIVITIES

7 COOPERATION

8 TRAINING

9 KEY COMMENTS, RECOMMENDATIONS AND ACHIEVED DEVELOPMENTS

9 LONG-TERM SOCIAL CARE INSTITUTIONS FOR ADULTS

10 CORRECTIONAL INSTITUTIONS

12 POLICE FACILITIES

12 PLACES OF DETENTION OF FOREIGNERS

14 MENTAL HEALTH INSTITUTIONS

16 FOLLOW-UP OF THE IMPLEMENTATION OF RECOMMENDATIONS

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INTRODUCTION

We are pleased to present the latest annual re- mental health, correctional institutions, police port of the National Preventive Mechanism and facilities and places of detention of foreigners and in doing so, welcome the growing confidence the number of visits to institutions in a particular and influence of the Lithuanian NPM. It is the area was planned in proportion to their number. 6th year the Seimas Ombudsmen‘s Office has It has to be stated here that unfortunatelly the been assigned the NPM functions and has been risk of ill-treatment for those detained in facilities monitoring places of detention n . The across Lithuania still exists. NPM members this United Nations’ Optional Protocol to the Conven- year continue to report concerns that detainees tion Against Torture (OPCAT) provides us with a are not being held in safe and decent conditions. crucial framework to strengthen our work mo- We have discovered poor physical conditions nitoring places of detention, and it encourages and conditions not fit for purpose, and excessi- us to focus even more carefully on preventing ill ve or improper use of restraints on some of the treatment in practice. most vulnerable detainees, including those in mental health detention, social care institutions Every time our NPM team members visit a place (especially persons with dissabilities), prisons where people are detained it increases open- and police custody facilities. For these reasons, ness and transparency. The visit creates a less we must recognise that however successful we closed atmosphere and gives those detained an are, we cannot do this work alone; we need to opportunity to voice their concerns. Importantly, welcome the parallel roles undertaken by experts it reduces the likelihood that the conditions of from non-governmental organisations (NGOs) detention will deteriorate any further and reduces and the media in exposing malpractice in the the chances that the detained person will be il­l- institutions we visit and inspect. Moreover, we treated. NPM members listen carefully to detaine- have to continue to engage widely with interna- es and staff, make recommendations for change tional and regional human rights bodies, such and bring forward improvements in conditions, as the European Committee for the Prevention reducing still further the risk of ill-treatment. of Torture and Inhuman or Degrading Treatment Moreover, at the core of the Lithuanian NPM’s or Punishment (CPT) and the SPT and other inter- work is a human rights approach, i.e. placing the governmental bodies. lived experience of detainees at the heart of the There is still much more to do; however, we know inspection and monitoring process and drawing that we are on the right path - by working toget- on international standards and best practice to her across the detention institutions in Lithuania, assess treatment and conditions in detention. NPM members can and do make a difference There are around 450 places of detention in each year. While the Lithuanian NPM continues Lithuania and during 2019 the Seimas Ombuds- to look for ways to strengthen our joint working men‘s Office as an NPM cunducted a total of processes we invite you to look into findings of 45 inspections. Visits were made to social care, the year 2019 below.

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This part of the Annual Report of the Seimas main issues identified during inspections; issued Ombudsmen presents the activities of the Na- recommendations on improving the human tional Prevention of Torture carried out in 2019: rights situation and training organised for staff the inspections at places of detention; systemic, of the places of detention, etc.

Adult care institutions are marked in yellow, child care institutions – in blue, police institutions – in black, prison institutions – in grey, places of detention of foreigners – in green, and mental care institutions – in red.

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NATIONAL PREVENTION OF TORTURE AND THE SEIMAS OMBUDSMEN’S MANDATE

On 3 December 2013, further to the ratification places of detention and observing how human by the Seimas of the Optional Protocol to the rights are enforced in them. The performance United Nations Convention against Torture and of the national prevention of torture requires Other Cruel, Inhuman or Degrading Treatment a comprehensive approach, where instead of or Punishment, the Seimas Ombudsmen were addressing individual situations, the aim is to assigned the task of performing the national identify possible causes of misconduct through prevention of torture at the places of detention systematic analysis of situations of restriction and inspecting them on a regular basis, while of liberty. These activities are aimed at positive the Seimas Ombudsmen’s Office was designated changes to prevent torture, reduce the risk of tor- as the Institution for the National Prevention of ture and ill-treatment and improve the treatment Torture. of persons whose liberty is restricted. The year 2019 was the sixth year when the Seimas The report below outlines the positive develop- Ombudsmen have been performing the national ments achieved in performing activities of the prevention of torture, regularly visiting various national prevention of torture.

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ACTIVITIES OF THE NATIONAL PREVENTION OF TORTURE

VISITS TO PLACES OF DETENTION places of detention (housing) of foreigners – 7 (seven) times (three units of the State Border In performing the national prevention of torture, Guard Service (SBGS) under the Ministry of the visits were made to various places of detention: Interior – the Foreigners Registration Centre social care, mental health, imprisonment, police (FRC), which was visited five times and two Border and other institutions. The number of visits to Inspection Posts); prisons – 7 (seven) times (seven institutions in a particular area is planned in prisons were inspected) and temporary detention proportion to their number. For example, the facilities of police headquarters – 5 (five) times largest number of visits was made to adult social (five temporary detention facilities of police sta- care homes as their number is the largest (over tions were inspected). 180 units).

In 2019, a total of 45 (forty-five) visits were made INFORMATION ACTIVITIES (several inspected institutions were visited two and more times). According to the proportion of In the context of national prevention of torture places of detention, the distribution of visits was and other activities of the NHRI, it is also im- as follows: adult care institutions were visited portant to ensure the proper dissemination of 20 (twenty) times (twenty adult care institu- information on human rights implementation tions were inspected), mental health care and inter-institutional cooperation; therefore, institutions – 6 (six) times (mental health de- the functions of the national prevention of partments of three hospitals were inspected torture and the results of their implementation arranging from one to three visits to them); are presented in different of Lithuania

CorrectionalCorrectional institutions institutions andand remand remand prisons prisons PolicePolice detention detention facilities facilities 55 MentalMental health health and and 99 communicablecommunicable disease disease 2525 185 MentalMental health health institutions institutions 66 treatmenttreatment institutions institutions 185 PlacesPlaces of of detention detention ofof foreigners foreigners 2020 5252 AdultAdult care care institutions institutions AdultAdult care care institutions institutions CorrectionalCorrectional institutions institutions andand remand remand prisons prisons 77 PolicePolice detention detention facilities facilities 6767 PlacesPlaces of of detention detention Child care and Child care and of foreigners socializationsocialization institutions institutions 9292 of foreigners 77

Number of places of detention in Lithuania Number of visits to places of detention in 2019

6 2019 REPORT ON NATIONAL PREVENTION OF TORTURE every year. These meetings are used to present that the shortcomings of the penal enforcement the national prevention of torture performed by system were also discussed by the Seimas Om- the Seimas Ombudsmen in social care institu- budsmen at the meeting of the Seimas Commit- tions, identify the most urgent issues of ensuring tee on Human Rights. human rights, analyse their potential solutions Employees of the Human Rights Division of the and discuss the organisation of adult care in Seimas Ombudsmen Office participate in various and the problems encountered. international cooperation events hosted for staff In 2019, such presentation was hosted in Telšiai of the national mechanisms for the prevention District for representatives of social of torture. In 2019, the employees participated, service management units and care institutions inter alia, in an expert meeting on the topic of responsible for the provision of long-term social ‘Treatment of vulnerable groups of prisoners’ care services to adults in Telšiai District Munici- organised by the European Union-funded pro- pality. ject ‘Working towards harmonised detention standards in the EU – the role of the NPM’, in Sofia (Bulgaria). The meeting was organised by COOPERATION the Bulgarian Helsinki Committee along with With a view to ensuring inter-institutional coope­ its partners (Hungarian Helsinki Committee, ration, in 2019, the Seimas Ombudsmen repeat- Ludwig Boltzmann Institute for Human Rights edly met with representatives of public groups, and the Association ‘Antigonė’). The purpose public authorities, international human rights of the meeting was to help the authorities organisations representatives of the staff of the and individuals performing the NPM functions places of detention, other responsible authorities, improve the monitoring of the protection of hu- such as the Ombudsman for Children, E. Žiobienė, man rights of vulnerable groups of the convicted representatives of the Lithuanian Trade Union (women, children, persons with disabilities,­ ‘Solidarumas’, representatives of the Ministry foreigners, homosexuals), motivating them to regularly share their knowledge and experience of Justice and the Prisons Department, public with foreign partners in the internet system authorities and non-governmental organisations (platform) and to develop the joint document/ on the implementation of recommendations handbook for monitoring human rights. During issued by the United Nations Committee on the the event, the organisers presented the joint Rights of Persons with Disabilities, representatives document (guide) and the internet system of the International Organisation for Migration, (platform) designed for the implementation representatives of the UN Refugee Agency, the of the functions of the national prevention of National LGBT Rights Organisation, and repre- torture as well as other objectives mentioned sentatives of the State Border Guard Service. above. More than four working groups were During the meetings such issues as draft legal formed and participant, following practical tasks acts, regulating enforcement of sentences and provided to them, could share their experience arrests assessing their compliance with human acquired in performing the NPM functions and rights standards, the situation in prisons as well could receive advice on arising challenges and as other issues were discussed. It should be noted their possible solutions.

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TRAINING On 22 October 2019, the Human Rights Division of the Seimas Ombudsmen’s Office organised In regard to the recommendations made by the training for employees of social care institutions. European Committee against Torture and Other During the training, employees of social institu- Violent, Inhuman or Degrading Treatment or tions were familiarised with the care of persons Punishment (CPT) to Lithuania on the need to in social care homes based on the principles of increase the competences of persons working human rights, thereby increasing and ensuring in places of detention in the fields of ensuring the quality of social services and respect for the human rights, as well as prevention of torture and human rights of the users of these services. other ill-treatment, by improving their skills and On 11 December 2019, the Human Rights Division expanding their knowledge, the Seimas Ombuds- of the Seimas Ombudsmen’s Office organised men seek to contribute to the development of training for the officers of correctional institu- the staff competences by organising training for tions to familiarise them with the supervision of employees of places of detention on the topics life sentences based on human rights principles. of restriction of human rights and freedoms in During the training, areas for improvement were places of detention. presented and analysed.

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KEY COMMENTS, RECOMMENDATIONS AND ACHIEVED DEVELOPMENTS

LONG-TERM SOCIAL CARE Public Institution Skaudvilė Palliative Treat- INSTITUTIONS FOR ADULTS ment and Nursing Hospital and Dūseikiai Social Care Home. In 2019, inspections were carried out in 20 The following main shortcomings identified (twenty) social care institutions (for adults with during the inspections should be mentioned: disabilities and elderly people): 1. Not all territories and premises of care insti- 1. 11 (eleven) care institutions in Telšiai : tutions as well as information provided by Plungė Parish Retirement Home, Public Ins­ them are adapted to the needs of persons titution Plungė District Municipal Hospital, with disabilities; people with disabilities are Care Home of Žemaičių Kalvarija ‘Caritas’ accommodated in premises not adapted to Division, Public Institution Parish their needs; in many institutions, the system Retirement Home, Public institution Rietavas of calling for assistance was flawed; Primary Health Care Centre, Telšiai District Retirement Home, Public Institution 2. The locking of the resident in his/her room is Primary Health Care Centre, Public Institu- applied; the right of the residents to privacy tion ‘Vilties erdvė’, JV Plinkšiai Care Home, (i.e. private, individual space, privacy of per- Mažeikiai District Orphanage and Retirement sonal hygiene or confidentiality of informa- Home and Public Institution Seda Primary tion, etc.) is not adequately guaranteed)2; Health Care Centre; insufficient attention is paid to discussing privacy issues with the residents; 2. 9 (nine) care institutions in Telšiai, Tauragė and Marijampolė counties1: Care Division 3. The relevant information about menus is of the Public Institution Kaltinėnai Primary not provided in a proper and timely manner, Health Care Centre, Kukarskė Care Home, JV adequate conditions for submitting requests Lauksargiai Care Home of Tauragė District for a range of foods and meals are not created; Municipality, Marijampolė Special Social Care there is no possibility for residents to make Home, Public Institution Marijampolė Pri- food themselves, nor eat in shared spaces; mary Health Care Centre, Pagėgiai Palliative Treatment, Nursing and Retirement Home, Seredžius Retirement Home, Care Division of 2 There is a particular lack of privacy in personal health care institutions providing care services, where a cosy home environment, privacy of medical examination, individualised supply of residents with underwear and upper clothing are 1 Repeated inspections to ascertain how recommendations not guaranteed, and there is a lack of facilities for private of the Seimas Ombudsman are implemented. communication.

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the residents receive only some cutlery During the reporting period, follow-up inspec- during meals, they have no possibility to tions of care institutions, which were inspected use all cutlery and no efforts are made to in 2015 and 2018, revealed that out of 177 (one encourage them to use it; hundred and seventy-seven) recommendations 4. Unfit for use medicinal products are still kept repeatedly submitted to them, 114 (one hundred (expired, not in original packaging of the pro- and fourteen) recommendations were imple- ducer); the contents of first-aid cases do not mented by the institutions, 40 (forty) were par- meet the requirements of their composition tially implemented and 23 (twenty-three) recom- laid down by the Minister of Health for such mendations were not implemented, i.e. eighty- cases; there is no control over how residents seven (87%) percent of the recommendations independently keep and consume various were implemented or partially implemented. In medicinal products in their living rooms; the regard to the circumstances established during residents have to purchase medicinal prod- the follow-up inspections (partly implemented ucts prescribed to them by the doctor also and/or unimplemented recommendations, as for their own account; and the accounting well as additionally identified shortcomings), of medicinal products is kept negligently; the Seimas Ombudsman submitted recommen- dations to each care institution and its founder, 5. There is lack of appropriate activities for the institution purchasing social care services residents: no plans for individual social care, (respective municipal administration)4 in order to no personalised organisation of appropriate take the necessary measures to address the iden- activities for residents, who are unable to tified shortcomings (for the proper implementa- get out of bed due to health reasons; lack of tion of the recommendations). In addition, 39 books and a wider range of activities focused on the needs of residents and enhancement (thirty-nine) recommendations were submitted. of their social skills. According to the data provided by the institutions in respect to follow-up inspection, all repeatedly Following inspections of care institutions in Telšiai submitted recommendations were implemented county, a total of 171 (one hundred and seventy-one) immediately after the follow-up inspection. recommendations were provided3: 165 (one hun- dred and sixty-five) – to heads of the inspected care institutions, 3 (three) – to county municipal CORRECTIONAL INSTITUTIONS administrations, 2 (two) – to the Department of In 2019, checks on the human rights situation were Supervision of Social Services under the Ministry carried out in 7 (seven) correction institutions: of Social Security and Labour and 1 (one) – to the Minister of Social Security and Labour.

4 An individual’s need for social care is established, a decision on the allocation of social services and social care 3 Given the Seimas Ombudsman’s instruction to report on is organised and the quality of social services allocated in the results of implementation of recommendations by 27 the municipality is ensured by the municipal administration; March 2020, competent authorities have not yet provided accordingly, the latter must take all necessary measures information on possible implementing measures of to ensure proper implementation of recommendations recommendations of the Seimas Ombudsman. submitted to care institutions.

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Lukiškės Remand Prison (Lukiškės RP), does not meet the minimum requirements of Correction House (Alytaus CH), Marijampolė natural light coefficients, accordingly, condi- Correction House (Marijampolė CH), Cor- tions are not created for ensuring minimum rection House (Vilnius CH), Pravieniškės Correc- natural lighting5; tion House – Open Colony (Pravieniškės CH-OC), 5. Possibilities to continue studying at schools Panevėžys Correction House (Panevėžys CH) and of general education and to work are not Šiauliai Remand Prison (Šiauliai RP). provided, thus violating their right to engage The following main shortcomings identified dur- in all kinds of meaningful activities, social ing inspections should be mentioned: rehabilitation documents of the relocated prisoners are handled only partially, their 1. No measures are taken to maintain social skills social skills development and healthy life- of the convicted transferred from Lukiškės RP style programmes are not implemented; to other correction institutions; the convicted have no access to literature 2. The right of the convicted to be informed of adapted to their needs, activities with public a specific transfer decision taken in respect organisations focused on moral education do of the convicted person is restricted, fa­mily not include other forms of positive activities members and relatives are not informed for the convicted or such meetings do not about the transfer in advance and condi- take place; there are no risk assessments of tions are not created for appeal against such criminal behaviour of relocated inmates, the a decision in accordance with the procedure number of websites available to relocated laid down by legal acts; inmates in different correction institutions ranges from 1 to 107, and in some institutions 3. When relocating persons to other correc- computer equipment is very outdated. tion institutions, the place of residence of the convicted and their spouses, family 60 (sixty) recommendations were issued to com- members and other relatives has not been petent authorities: 1 (one) recommendation was taken into account, thus preventing the issued to the Minister of Health (for improving convicted from effectively maintaining social legal regulation – the hygiene standard should relationships with the external world; for include the requirement to ensure natural this reason, relocation to other correctional lighting measured according to the natural institutions was favourable for maintaining lighting coefficient), 2 (two) – to the Director social relationships with relatives only to one of the Prison Department; in addition, control third of inmates; the number of living rooms of recommendations submitted to subordinate for long-term visits is smaller than provided institutions: Alytus Correction House – 9 (nine), for by legal acts; Marijampolė Correction House – 10 (ten), Vil- nius Correction House – 8 (eight), Pravieniškės 4. Material housing conditions are not ade­ quately guaranteed, the lighting of cell-type premises in correction institutions, where 5 Natural lighting coefficients do not correspond to even the life prisoners and persons sentenced by the minimum established analogue natural lighting coefficient, court to serve a prison sentence are placed, which must be at least 0.5%.

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Correction House-Remand Prison – 10 (ten), During inspections the following main short­ Panevėžys Correction House – 9 (nine) and comings were identified: Šiauliai Remand Prison – 11 (eleven). 1. Legal acts are not published and/or their ap- Data provided by the competent authorities plicable version is not available in the Register on the results of the implementation of the of Legal Acts and on the website of the Police recommendations showed that the Prison Department; Department implemented 2 (two) recommen- 2. There are cases when not all data is recorded dations, Alytaus Correction House – 9 (nine), in the Register of Police-Registered Events; Marijampolė Correction House – 7 (seven) (three recommendations not implemented or imple- 3. Not all PS premises for interrogation of adults mented improperly), Vilnius Correction House – have video surveillance systems; the mini- 7 (seven) and 1 (one) recommendation was mum retention period of video surveillance not implemented or implemented improperly, records concerning the imprisoned is not Pravieniškės Correction House-Remand Prison – guaranteed; 8 (eight), 1 (one) recommendation was not 4. Adequate material housing conditions for implemen­ted or implemented improperly; detainees are not guaranteed. moreover, Pravieniškės Correction House- Remand Prison failed to provide implementa- Following the inspections, the responsible au- tion information in respect of 1 (one) recom- thorities – the Ministry of the Interior (MoU) and mendation, Panevėžys Correction House – the Police Department (PD) under the Ministry 9 (nine), and Šiauliai Remand Prison – 9 (nine) and of the Interior were issued 8 (eight) recommen- dations: 1 (one) recommendation was issued 2 (two) recommendations were not implemented to the MoU (on improving the legal regulation or were implemented improperly. Measures for of police activities – to ensure that all legal acts implementing the submitted recommendation adopted by the Lithuanian Police Commissioner are being revised with the Ministry of Health. General and their amendments are published in the Register of Legal Acts and on the PD POLICE FACILITIES website) and 7 (seven) recommendations – to the PD. The results of the implementation of During the reporting period, the assessment of the recommendations reported by the compe- the human rights situation at temporary deten- tent authorities show that all recommendations tion facilities of police stations (PS) included are being implemented – prepared plan of meas- a total of 5 (five) police stations: Švenčionys ures for implementing the recommendations is District Police Station of Police fulfilled within the established time limits. Headquarters and Ukmergė District Police Sta- tion, Anykščiai District Police Station of PLACES OF DETENTION OF County Police Headquarters, District FOREIGNERS Police Station of County Police Head- quarters and District Police Station of In 2019, the Seimas Ombudsmen assessed the Police Headquarters. human rights situation in 3 (three) State Border

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Guard Service (SBGS) facilities: SBGS Foreigners’ cell-type premises, the proportionality of Registration Centre (FRC) (five inspection visits the extreme measure (detention) taken to carried out), the Coast Border Guard at the Port achieve the objectives and its compliance Border Inspection Post (Port Border Inspection with children’s best interests is not assessed; Post) and Border Control Post of Palanga 7. The vulnerability of asylum seekers is assessed Airport (Airport BCP). ineffectively and inefficiently because of: the During the inspections the following main short- lack of knowledge of foreign languages by comings were identified: the staff, lack of opportunities to improve the staff qualifications, problems of the organisa- 1. Part of the premises of the FRC, including its tion of work (including the allocation of the administrative premises are not adapted for workload of staff performing assessment, the disabled; accommodation for persons with disabilities does not always take due proper filling in and storage of assessment account of their physical abilities to live in documents), lack of mobilisation of compe- the respective premises; tent external authorities and specialists; lack of cooperation with specialists of the State 2. The cleanliness and order in the premises is Child Rights Protection and Adoption Service not properly ensured; the standards of sup- in order to adequately ensure the rights and plying inmates with hygiene articles, in terms legitimate interests of the child; failure to of quantity and frequency of supply (including ensure the interpreter’s services; failure to diapers for babies under one year of age only) ensure the smooth operation of the electronic are insufficient to ensure personal hygiene; registry system of the Port Border Inspection 3. The offered alternative menu is not adapted Post and Airport BCP, which makes it more to foreigners confessing to Islam, conditions difficult for officials to work on the processing are not created for foreigners to perform cer- of the provided personal data; administrative, emonies according to their professed religion temporary detention and asylum seekers’ in a separate facility adapted for that purpose facilities are not adapted for the disabled; within the territory of the FCR, not all persons minimum natural and/or artificial lighting is with special nutritional needs are provided not ensured. with separate menus; it is not ensured that all Following the inspections carried out in the children attending school can have breakfast Foreigners Registration Centre (FRC), 24 (twenty- in the canteen before school starts; four) recommendations were issued to the 4. There is no clear procedure for submitting and responsible authorities – the Ministry of Health handling requests, complaints concerning (MoH), MoI, SBGS, FCR and the State Health Care food supplied in the canteen; Accreditation Agency under the Ministry of Health (Accreditation Agency): 1 (one) recom- 5. Quality healthcare services and timely access mendation was submitted to the MoH (for the to them is not guaranteed; improvement of legal regulation – providing in 6. In the case of applying detention when a the hygiene standard for larger rates (quantities) family (a mother with minors) is placed in and wider range of hygiene articles provided to

13 2019 REPORT ON NATIONAL PREVENTION OF TORTURE one person); 2 (two) recommendations – to the Brach of the Public Institution ‘Respublikinė MoI (for the improvement of legal regulation – to Klaipėdos ligoninė’ (hereinafter – Klaipėda Hos- recalculate and change daily rates of costs for pital), the Psychiatry Department of the Public meals established for adults and minors placed in Institution ‘Respublikinė Panevėžio ligoninė’ the FRC, taking into account the current average (hereinafter – Panevėžys Hospital) and the Child market prices for agricultural and food products, Psychiatry Department of the Woman and Child also to establish a third option of meals, i.e. to Clinic of the Public Institution ‘Respublikinė include in the menu dishes from meat other Šiaulių ligoninė’ (the report is being prepared). than pork; to ensure the right to adequate food The President of the Lithuanian Disability Forum, accor­ding to religious beliefs; 5 (five) recommen- Dovilė Juodkaitė, was involved in the inspections dations were submitted to the SBGS (of which 1 as the expert of mental health and rights of the (one) – for the improvement of legal regulation of disabled. the SBGS activities – to supplement the question- The following main shortcomings identified naire form of the arriving alien in order to ensure that his/her special nutritional needs are identi- during the inspections should be mentioned: fied immediately), 15 (fifteen) recommendations 1. No approved workloads for doctors and other were submitted to the FRC and one (1) – to the health care specialists; staff complained about Accreditation Agency. All recommendations were high emotional pressure, lack of incentives, implemented except for the recommendation costs of refresher courses not always covered submitted to the MoH (no information about the by the administration of the institution; implementation of the submitted recommenda- tion has been received yet). 2. The provisions of the internal rules defining the procedures for involuntary hospitalisation Inspections carried out at the border inspection of patients do not comply with the existing posts and border control posts resulted in 6 (six) legal regulation; not all patients know about recommendations: 5 (five) recommendations their right to refuse to continuing their hos- were issued to the SBGS and 1 (one) – to Klaipėda pitalisation and treatment at the institution Department of the National Public Health Centre and are not properly informed about the under the Ministry of Health. According to the treatment regime; information provided by the institutions about the results of implementation of the recommen- 3. The access to information on internal rules dations, all recommendations were implemented: of the institutions, patients’ rights and the plan of measures drawn up for the imple- responsibilities, possibilities to apply to mentation of the submitted recommendations the institutions’ ethics commissions is not was implemented within the time limits set out ensured; patients lack information on the in the plan. procedure for submitting written requests, the ethics commissions and their functions, oral requests of patients are not registered, MENTAL HEALTH INSTITUTIONS the possibility of anonymous referral is not In 2019, inspections were carried out in three (3) adequately guaranteed in most of the visited mental health institutions – the Mental Health departments;

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4. The applicable procedure of physical restraint 6. Provisions of national legal acts prohibiting arrangements are not in line with the exist- the use of tobacco products and e-cigarettes ing legal regulation, no attention is paid to in all health care establishments and their ter- improving staff qualifications in the light of ritories are infringed, smoking of patients is new legal regulation, the privacy of patients, tolerated both by passive and active actions subject to physical restraint measures, is of administrations and staff, and smoking not ensured; the monitoring of the state of addiction prevention programmes are not intended periodicity and the proper registra- applied; tion of the application of restraint measures 7. Access to the psychologist’s services, psycho- is not guaranteed; social rehabilitation and leisure activities is not 5. Not all facilities are adapted to the needs of properly ensured (the majority of departments persons with reduced mobility; equipment have no separate rooms for recreation / activi- in hygiene facilities are disorderly, there is a ties, patients are rarely taken out for walks). lack of cleanliness, no curtains in wards, inad- In the light of the identified shortcomings rec- equate ventilation of premises, premises for ommendations will be issued to the responsible meetings with visitors are not installed, thus authorities to address these shortcomings and failing to ensure the privacy of patients and the implementation of the recommendations people visiting them; will be monitored.

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FOLLOW-UP OF THE IMPLEMENTATION OF RECOMMENDATIONS

The follow-up of the implementation of recom- mentation of recommendations of the Seimas mendations provided to the responsible institu- Ombudsmen through the on-site assessment of tions is a very important measure of ensuring the the information submitted by the institution (as national prevention of torture. In implementing already mentioned, in 2019, nine (9) follow-up the submitted recommendations competent inspections were carried out in the adult care institutions must take certain actions, if neces- institutions). sary, provide for the action plan, and the Seimas A high average (94%) of the number of imple- Ombudsmen monitor the implementation of mented recommendations is encouraging. Re­ these recommendations. The follow-up of the im- commendations that remain not implemented plementation of recommendations is a process in are the subject of the continuous dialogue seek- which the institution responsible for preventing ing to have all of them implemented; the relevant torture monitors and gathers information on the information will be included in other reports of actions and measures taken by the responsible the Seimas Ombudsmen’s activities. institutions in accordance with the recommen- dations provided to them, promotes the proper 200 177 implementation of recommendations in different 180 160 154 (87 %) ways, and consults on the effectiveness of the 140 120 selected measures. 100 80 60 51 (85 %) 60 39 39 (100 %) 29 (97 %) 40 30 8 8 (100 %) The follow-up of the implementation of recom- 20 0 mendations provided to the responsible institu- Follow-up Implementation of Inspections in Inspections in Inspections at inspections in recommendations correction police facilities places of tions is carried out by assessing the information adult care after the follow-up institutions and detention of institutions inspections remand prisons foreigners received from the responsible institutions, adjust- Submitted recommendations (units) Implemented recommendations (units) ing such information and conducting follow-up inspections to determine the results of imple- Implementation of submitted recommendations

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